Predictors and clinical significance of periprocedural myocardial infarction following rotational atherectomy

Catheter Cardiovasc Interv. 2022 May:99 Suppl 1:1440-1447. doi: 10.1002/ccd.30095. Epub 2022 Jan 25.

Abstract

Objectives: To investigate the potential predictors and clinical significance of periprocedural myocardial infarction (PMI), as defined by the latest Fourth Universal Definition of Myocardial Infarction (2018), following rotational atherectomy (RA).

Background: PMI is not uncommon in patients undergoing RA, although the predictors and prognostic impact are unknown.

Methods: Data from 229 consecutive patients who had undergone RA before drug-eluting stent (DES) implantation in a single center were analyzed. Patients' demographic information, clinical, angiographic, and procedural characteristics, and 1-year follow-up outcomes were collected retrospectively.

Results: The overall incidence of PMI in patients undergoing RA was 48.5%. Age (adjusted odds ratio [OR]: 1.024, 95% confidence interval [CI]: 1.001-1.047, p = 0.043) and ejection fraction (adjusted OR: 0.977, 95% CI: 0.962-0.993, p = 0.004) were independent predictors of PMI in RA, although PMI was not associated with an increased risk of major adverse cardiovascular and cerebrovascular events (MACCEs) at the 1-year follow-up in patients undergoing RA.

Conclusion: Age and ejection fraction were independently associated with an elevated risk of PMI in patients undergoing RA. However, post-RA microinfarcts were not associated with an increased risk of MACCEs over the short-term follow-up period.

Keywords: aging; coronary disease; risk factors.

MeSH terms

  • Atherectomy, Coronary* / adverse effects
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Drug-Eluting Stents* / adverse effects
  • Humans
  • Myocardial Infarction* / epidemiology
  • Myocardial Infarction* / etiology
  • Percutaneous Coronary Intervention* / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome